Comprehensive analysis of COVID-19 during pregnancy

Abstract

The COVID-19 pandemic resulting from the emergence of the coronavirus SARS-CoV-2 remains a major global health concern. Pregnant individuals are more likely to develop severe COVID-19 and a number of pregnancy complications have been observed in COVID-19 patients. To date, little is known about the impact of COVID-19 on pregnancy. In this review, we examine key aspects of pregnancy that may be impacted by COVID-19 and summarize the current literature on SARS-CoV-2 infection of the placenta and in utero vertical transmission. Furthermore, we highlight recent studies exploring the role of the maternal antibody response to SARS-CoV-2 during pregnancy and the passive transfer of maternal antibodies from mothers with COVID-19 to fetus.

Intrauterine vertical SARS‐CoV‐2 infection: a case confirming transplacental transmission followed by divergence of the viral genome

“…In contrast, receptors for Zika virus and cytomegalovirus, which cause congenital infections, are abundant in placental cell types. To the best of our knowledge, no studies have demonstrated SARS‐CoV‐2 cellular entry via ACE2 binding or replication within placental cells 21 …”

ACE2 Is Expressed in Immune Cells That Infiltrate the Placenta in Infection-Associated Preterm Birth

“…There is also a growing body of evidence demonstrating SARS-CoV-2 infection of the placental membrane and the villous trophoblasts via a variety of different laboratory techniques such as PCR [ 56 , 57 , 58 ], positive strand in situ hybridization [ 58 ], immunohistochemistry [ 56 , 57 ], and transmission electron microscopy [ 59 ]. These studies have shown that SARs-CoV-2 infection is limited to the syncytiotrophoblast, and is rare occurring in approximately 2% of all cases [ 60 ].…”

SARS-CoV-2 infection during pregnancy and pregnancy-related conditions: Concerns, challenges, management and mitigation strategies–a narrative review

“…In addition to common deleterious effects, alteration in mothers' psychological status, including anxiety and depression, and infant’s neurobehavioral development have also been noted [ [19] , [20] , [21] ]. Some important issues of SARS-CoV-2 infection in pregnancy and pregnancy-associated conditions need to be elucidated fully by focusing in several critical aspects to minimize the impacts of this pandemic in women and the neonates [ [22] , [23] , [24] , [25] , [26] ]. Critical discussion is therefore required to evaluate the magnitude of COVID-19 problems in pregnant women to be able to constitute preventive measures to prevent mortality.…”